More medical students are refusing pharmaceutical handouts. “‘People will often ask, ‘why didn’t you take the pen? Or, why didn’t you eat the lunch?’,’ says Kenyon, a Boston University medical student who packs a sandwich, apple, and granola bar almost every day so he won’t have to eat meals sponsored by drugmakers.

‘It gives you the green light to talk about it when somebody asks,’ adds Petersen, who swears his home-cooked pot roast and clam chowder leftovers taste better than the catered meals he refuses each week.”

I wonder how many medical students have the time to bring home-cooked pot roast every day to work. More likely is that these students, already $100,000+ in debt, will just spend more money in the cafeteria when refusing pharma-sponsored lunches.

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  • jb

    Moral preening never goes out of style.

    These students, once they graduate into practicing physicians, will learn that pharma reps can be good sources of information, as long as they are viewed as marketing shills who spout what they are programmed to say. I sometimes tell them, show me a double blinded controlled peer-reviewed study that show that your $3 pill works better than the 10 cent generic I usually prescribe, and I will change what I prescribe. Sometimes, they do have such a study, and sometimes I do change. Usually they go away, but not before leaving a supply of samples that I give to my indigent patients.

  • Anonymous

    Doctors script out drugs that are biased towards effective drug marketing and not necessarily the best medication.

    Now, there are 2 possible reasons for this:

    1) Doctors are afraid they will lose out on the free pens and lunches and therefore consciously or subconsciously make a biased decision to push the drug.

    2) Doctors script out the drug, not because they care about free pens or lunches, but simply because they are more familiar wtih that drug in particular and not as familiar with the other drugs that they didnt get exposed to thru marketing.

    I choose option #2. The reason drug scripts are biased towards marketing is because doctors happen to be more familiar (or misinformed perhaps) via drug marketing, not because its a “tit for tat” payback scheme.

  • joanna

    Wow, there is hope for our profefssion after all. Bravo, young cooking doctors.

    I work for the FDA as a medical reviewer. I applaud the effort of young doctors to be unbiased and wisely critical.

    I strongly disagree with those doctors who say that drug reps are good for something.

    Yes, you may get networking info, or free drugs for the indigent. But it comes at a price of the indigent. You can network outside of drug reps.

    And one the reasons that the “indigent” could not afford the drug in the first place was that drugs were made to produce a profit.

    Strong work! I for one, will NEVER ever attend a drug dinner/luncheon or free event.

  • Domenico Savatta, MD

    Interesting debate:

    I am a urologist in a 9 urologist group who often get free smaples and 1-2 lunches per week for our office.

    We also perform clinical studies that are sponsored by drug companies.

    I for one, think drug reps do far more good than harm.

    I have only been in practice 3 years, but think the appropriate backlash against industry dates back to the free trips, free cars, and other outrageous gifts from the distant past.

    Most physicians are too busy to find out about drugs from independent resources.

    If none of the docs took any free stuff, there would be tens of thousands of reps out of a job.
    Drug sales would go down since docs wouldnt know about them.
    Money for R&D would go way down, as would profits.
    New drugs would be rare.

    I challenge these students to explain what would happen in an “ideal world” where docs completely shunned industry.
    I think that world would be far worse then what we have now.

    Other sources of “drug money” are CME sponsored events and conferences, as well as other educational events that docs need and money might not otherwise be there for.

  • Anonymous

    Dr. Savatto,

    You are a clueless prostitute. I can say that because I am a doctor.

  • R. W. Donnell

    Kevin,
    Dig deeper into the activities of AMSA. See my post on this subject.

    http://doctorrw.blogspot.com/2006/01/amsa-claims-to-take-moral-high-ground.html

    jb,
    Yes, it is moral preening. Aptly put.

    Anonymous #2,
    Strong words. Care to identify yourself?

  • Anonymous

    While I admire these med students for their conviction, it seems a little overdone. Todsy we have commercials in movie theaters, innumerable commercials on TV for prescription meds, and banners on websites promoting meds. We all get spam telling us we can buy certain meds cheaper and without prescriptions.

    In short, we live in a world innundated by advertisements. Drugs reps are part of that world – one that thinks it must CONSTANTLY market its product. Drug reps aren’t going anywhere; they’re here to stay. And if a few med students get a free lunch or 2 out of them, so be it. I know very few practicing docs who base their prescribing on what drugs reps told them in med school. And if some day that med student becomes a resident and writes for something too expensive or “out there,” an attending will comment on it.

    Going hungry is the med students’ way of “fighting the system” – it’s a phase that will pass.

  • Anonymous

    Do I take their food? no
    Do I take their pens? no
    Do I take their free samples? You bet. Why, because I regularly see people who for whatever reason cannot pay for their meds yet (medicaid pending etc). I suspect most of you high and mighty types in reality are like joanna who have little clue as to what day to day doctoring involves. It is easy to pontificate when you work for the government in a job that doesn’t even involve direct patient care.

  • Anonymous

    “Do I take their free samples? You bet. Why, because I regularly see people who for whatever reason cannot pay for their meds yet (medicaid pending etc). “

    I work at an inner city hospital where drug companies are banned. We don’t give away free samples of “Ketek”
    to the homeless. We still use meds like Doxy and Bactrim. We also have EXTREMELY low rates of resistance against pathogens. I think this is more than just a coincidence.

  • Anonymous

    Giving away free sample medications is unethical for a doctor unless its literally a curative drug that only needs to be used for a limited period (e.g. some antibiotics).

    Giving away sample medication for illnesses that cant be cured (e.g. diabetes, HTN, etc) is unethical because it forces others to pay for the meds and increases healthcare costs as a whole while providing little aggregate benefit to the recipients of the free drugs.

    These samples are not “free” after all. Pharma companies calculate how many free samples they will give away that year and incorporate that cost into the price for the medication. They arent giving away anything for free and youd better not be naive enough to believe they are taking it out of the CEO’s bonus

  • Anonymous

    “We still use meds like Doxy and Bactrim.”

    When is the last time you had samples of bactrim or doxy to give out? Unless your “inner city pharmacy” is giving out the meds. I don’t have that luxury.

    “Giving away sample medication for illnesses that cant be cured (e.g. diabetes, HTN, etc) is unethical because it forces others to pay for the meds and increases healthcare costs as a whole while providing little aggregate benefit to the recipients of the free drugs.”

    So you are saying when someone who walks in the door with continued BP’s of 180/110 in which HCTZ hasn’t touched, they can’t afford a B-blocker or an ACE and I should just say “screw you”? You clearly don’t practice medicine.

  • Kathleen

    When I had my Whipple I specifically requested Protonix, by name, knowing it was the only PPI that worked on me. I was told it was too expensive and given something that didn’t work only later to be switched to a Protonix via drip and sent home with lots of Protonix in pill form. I pay a $200 co pay for my Protonix. I consume it, Give me the pen! (and as soon as I can eat, lunch would be great too)!

  • Anonymous

    I have never sold pharma products but sold surgial devices for 20 years before moving into management. Drug reps are treated by many physicians as a necessary inconvenience because they are not a true asset to his practice. I know the surgeons that I worked with never felt that way about me or my colleagues. We were there to help them become better trained so they could grow their practice by offering the best care available. I never did lunches and never did the smoke and mirror routine. If I had to buy your time with lunch or a pen then so could my competitor. The only time that I was treated rudely was from office staff because I did not bring them goodies. Never had a better time than in the OR and formed lasting friendships with many of my docs.

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